Inquire About The Cost And Availability of Physical TherapySo That We Can Meet Your SPECIFIC Needs, Please Fill Out This 35 Seconds Form And Show Us EXACTLY How You Want Us To Help YOU… The more we know about you, the better we can help you… Step 1 of 3 - About You 33% Please Enter Your First Name* First Primary Reason For Wanting To Sample Physical Therapy*I'm new to Physical Therapy and not sure what to expectI was let down by another therapist in the past and would like to see how good you are before I commitI'm NOT sure if Physical Therapy can even help meI'd like to get a feel for what you can do to help me BEFORE I commit to a full appointmentWhere Does It Hurt?*Please Select OneLower BackKneeShoulderNeckFoot/AnkleMuscle Injury from Sport/ExerciseNot Sure Where It's Coming FromWhat Does It STOP You From Doing?* What Is Concerning You Most That Makes You Want To Consider Physical Therapy?*Please Select OneThe Pain You Are ExperiencingWorry Over Not Knowing What Is WrongConcerns at No Signs of ImprovementWant to Avoid PainkillersFear of Not Being Able to Be ActiveHow Long Have You Suffered Or Worried?*A Few Days1-2 Weeks2-4 Weeks1-3 MonthsLong EnoughToo Long (Years)The Main Goal You Would Like Us To Help Achieve For You*Please Select OneEase PainEase StiffnessGet ActiveStay ActiveAvoid Painkillers DependencyFind Out What's WrongStay Health and Get Fixed BEFORE Pain Gets Worse Phone Number*Please tell us where to contact you with the outcome of the Free Taster Session application:Best Email* This iframe contains the logic required to handle AJAX powered Gravity Forms.